The VIN News Service recently conducted a Q&A session with the American Veterinary Medical Association and its indemnity arm, the Group Health and Life Insurance Trust (AVMA-GHLIT). The discussion explores the controversial partnership that’s emerged between GHLIT and Pets Best Insurance, a private entity.

Wallace, a 2-year-old Welsh corgi, wore a Voyce sensor on his collar for most of last year until the product went offline in December.

On its websiteand in news releases, the maker of an electronic “smart” collar for dogs and cats asserts that “four out of five independent veterinarians recommend a health monitoring collar like PetPace.”

No evidence exists, however, to support the suggestion that veterinarians collectively are saying anything about this new technology. PetPace officials asked about the “four out of five veterinarians recommend” statement cited a marketing survey but declined to provide details.

The short history of electronic wearable health monitoring tools for pets indicates, if anything, uncertain acceptance. While individual practitioners or researchers may be eager adopters, the veterinary community as a whole appears to be withholding judgment while the number and variety of devices proliferate.

An unscientific surveyin January of members of the Veterinary Information Network, an online community for the profession, suggests the devices are a novelty about which many veterinarians know little — and may not care to know.

Of 2,339 respondents, only 4 percent said they were familiar with the devices and are considering recommending them. By comparison, 20 percent said they were neither familiar with the devices nor considered them worthy of further investigation. Fewer than 1 percent of respondents were both aware of and recommending the products.

Introduced in May 2015, PetPace is one of a fast-growing number of wearable electronic gadgets for pets. Competitors sport names such as FitBark, Link AKC, PitPatPet, Poof, Tabcat, Tractive, Vetrax and Whist. Colloquially, the monitors sometimes are called Fitbits for pets, although the well-known activity tracker for people doesn’t come in a pet version.

The gizmos for animals take the form of collars or sensors that affix to collars or are worn in other ways. The devices feature technology designed to track a variety of physical metrics in animals —usually dogs and cats, though not exclusively.

Purchasing a smart-collar type of device can mean buying into a system that records, stores and analyzes data to be shared with owners and veterinarians. What the products measure and for whom the resulting data is intended varies.

The products on the whole aren’t cheap. For example, PetPace costs $150 upfront and $15 a month thereafter. In January, the company offered $80 off to owners who included their pets in healthy New Year's resolutions — a tip-off that price may be a barrier. Now the company is offering an $80-off "spring special."

Vetrax runs $99.95 plus $16 a month for a monitoring and notification service. At the lower-cost end are Poof, which starts at $39.99, and PitPatPet, a product sold in the United Kingdom for 39.99 pounds.

Voyce pulled in December; others debut

One of the early entrants to the field, Voyce, stumbled out of the starting gate. The product debuted in July 2015, lost money by the millions and was taken offline 18 months later. “Voyce was awash in red ink,” Veterinary Practice Newsreported.

Albert Di Rienzo, chief science and operating officer for Voyce, said the company that owns the product, Intersections Inc., terminated the commercial effort to “restructure and refocus.”

“Instead of continuing to spend at the rate we were, it was decided to take it down and focus on scientific and technological opportunities,” Di Rienzo said. “If you introduce an innovation that is not part of normal work flow, or for which people are not trained, it takes a while for it to become second nature [to use].”

Voyce is a sensor that uses ultra-wideband radar, a radio technology that Di Rienzo described as “almost like an ultrasound that sends energy into the animal, which hits structures in the body and reflects a signal back.”

The device differs from other wearables in that it doesn't require contact with the animal's body, he said: It can be placed on the side of a rodent's cage, on a horse’s bridle or hung around a cow's neck, for example.

Among its problems at market was the difficulty laypeople had interpreting the sensor-generated data, Di Rienzo said. Also, the device did not offer location tracking, which, the company learned, consumers favor.

DiRienzo said the company is retooling the product and intends to reintroduce it later this year.

Voyce’s difficult start hasn’t deterred others from diving in.

AGL, a company in Atlanta, working in partnership with Hill’s Pet Nutrition Inc., introduced Vetrax in February. Launched at the North American Veterinary Conference in Florida, Vetrax is pitched to the veterinarian rather than the pet owner: It’s available only through the recommendation and oversight of a veterinarian. “Everybody else goes to the consumer, but veterinarians are better at helping pet owners read the data in relationship to biology,” AGL Chief Operating Officer Joe Young said.

Dogs wear the Vetrax sensor on their collar, which transmits information to pet owners through a Vetrax app. Veterinarians access the data using a password-protected site on the internet.

Young said Vetrax distinguishes itself by honing in on specific pet behaviors, such as shaking and scratching, that are “relevant to medical treatment.” For example, he said, the device enables veterinarians to detect changes consistent with the development of arthritis and dermatological conditions before the onset of clinical signs. It also evaluates nutrition and weight-management regimens and reviews the activity of patients following surgery.

Hill's, an established pet-food brand, is leveraging its partnership with Vetrax by marketing to pet owners using the tracker: Those who sign up to buy $50 worth each month of any of three Hill’s diets — “derm defense,” “weight plan” or “arthritis plan” — get their $16 monthly Vetrax fee refunded.

Young agreed with Di Rienzo that when a pioneering technology enters the market, “time is needed for the uptake.”

For its part, PetPace has taken the market by storm — or so its global expansion and vigorous marketing would imply. Launched in the U.S. in May 2015, the monitoring collar now is sold also in Canada, the United Kingdom, European Union member countries and Australia.

Chief veterinary scientist Dr. Asaf Dagan said PetPace's clientele includes veterinarians in primary care facilities, research institutions and industries such as pharmaceuticals, pet food and supplements. He declined to disclose sales figures. “I can say that we have thousands of clients and that demand is continuously increasing,” he said.

The collar tracks temperature; pulse; respiration; heart rate variability, calories burned; activity; and body positions. It sends data at intervals of two-, 15-, or 30-minutes to a “health monitoring service” for analysis and alert in the case of deviations from the pet’s normal health profile, Dagan said.

He noted that animals typically are treated only after their clinical signs become clear to owners. The collar can alert owners earlier by registering subtle changes in the animal’s physiology. “We find deviations from patterns,” he said. “We can develop an 'individual normal range' of biometrics as opposed to the generic 'normal range.' The system is saying this specific dog has a heart rate of x, and when we see it's y, we know it’s abnormal.”

Information from the monitor is stored in a cloud database, which Dagan said can amass an "unprecedented" amount of information about an individual pet's health.

PetPace maintains legal ownership of the data, Dagan said, while “users have full access to data generated by the collars they own, and they can download and save the raw data anytime and without any limitations."

Studies underway

It's an open question how effective the devices are in providing useful early alerts to serious health conditions; or in preventing illness by, for example, motivating owners to change their pet’s diet or provide more exercise.

Voyce is involved in three research studies trying to find answers. One, at Cornell University, focuses on early indicators of osteoarthritis, with 30 to 40 dogs as subjects. “We’re trying to see whether there are signs we can pick up well in advance of an animal showing pain,” Di Rienzo said.

A project at the University of Pennsylvania focuses on blood pressure, applying the technology in an effort to “pick up on hypotensives and hypertensives,” while a third project, at Texas A&M University, is looking for early indicators of congestive heart failure, Di Rienzo said.

An earlier study conducted jointly with Cornell and Penn tested the accuracy of Voyce’s ultra-wideband radio sensing technology for measuring heart rates and respiratory rates in dogs. Researchers compared readings from Voyce with readings from gold-standard technology (the Televet 100 EKG) and readings obtained manually through auscultation and palpation. The Voyce technology stacked up well, with accuracy greater than 86 percent, according to a presentation at the 2016 American College of Veterinary Internal Medicine Forum Research Report Program, a synopsis of which was published in the Journal of Veterinary Internal Medicine.

Selling to Uncle Sam

PetPace recently received a $198,000 award from the U.S. Department of Homeland Security to assess the collar's ability to provide real-time health monitoring of dogs working for U.S. Customs and Border Protection (CBP).

CBP fields in excess of 1,500 dog teams trained to sniff out firearms or currency, and as search-and-rescue crews. Border climates can be extreme, and the program will entail gathering data, during training, with an eye to improved field care of and performance by the animals.

The grant is one of five under what CBP calls the K9 Wearables Solicitation and thus, not the last public money that will be spent on dog-collar research and development.

PetPace, too, is engaged in studies, in partnership with BluePearl, a string of veterinary specialty and emergency animal hospitals owned by Mars. Dr. Teresa Lightfoot, BluePearl's director of clinical trials, said the company has been working with PetPace since 2011 and helped develop the system's software. The companies declined to divulge the exact nature of their business relationship.

Lightfoot said BluePearl has purchased 20 PetPace collars that it uses on patients, and PetPace loans them additional collars for research, which include a cardiac study; pain-monitoring research that tracks variations in heart rate as a sign of distress that an animal may not show in behavior; and post-anesthesia hypothermia in dogs. “When we are alerted by the collar to their being hypothermic, we can apply heat in a timely fashion,” Lightfoot explained.

PetPace's website lists a number of case studies in which the collar is said to have helped animals with a panoply of ailments. For example, elevated pulse levels in a cat detected by the collar reportedly led to a diagnosis of hyperthyroidism. In another case, with the collar acting as monitor, a puppy expending more calories than it was taking in was discovered to have frequent bursts of energy at night, when he otherwise would have been unobserved.

Another potential benefit touted by advocates of wearable health-and-activity monitors is weight loss.

Dr. Caroline Goulard, a private practitioner in Laguna Woods, California, said the devices enable her to keep pet owners involved, to prod them into increasing their pets’ activity levels. “I love the collars for use in addressing obesity,” she said.

While there’s no published study on the effectiveness of trackers to help pets trim down, a recent University of Pittsburgh study published in the Journal of the American Medical Associationreported that fitness devices didn’t help people shed weight as much as other methods.

They might even have hindered weight loss.

The study didn’t attempt to tease out the reason for the surprise result. But John Jakicic, lead author of the study, told the New York Times that the trackers, by showing participants when they were far from their daily exercise goals, might have led study subjects to give up on those days.

Another possibility, Jakicic told NPR, was that participants might have rewarded themselves with extra food on days when their trackers showed high activity, rationalizing, “Oh, I exercised today, now I can eat more.”

Dagan doesn’t believe the JAMA study findings are applicable to devices used on animals because, he argues, animals wouldn’t be aware of the device or the data it transmits. Jones at Vetrax said the same, noting that the study involved “self-monitoring,” which pets cannot do.

Fad or future norm?

As an executive in a company that struggled to generate consumer demand, Voyce's Di Rienzo said he believes the devices in general face several impediments, including the perception that they’re merely a novelty. “Most do not collect and report clinically actionable information. Most are a fad, which is why they end up in a drawer after a few months,” he said.

The nature of the technology also can pose a hurdle.

Dr. Donna Korvick, a research veterinarian at a company that deals in surgical devices, related that she wanted to use the PetPace collar on laboratory pigs but was unable to obtain permission from the information-technology department.

Dagan explained that PetPace requires an internet connection to access its data, and that Korvick’s company would not allow PetPace devices to connect to the internet through its network. The problem wasn’t technical, Dagan said, “just a matter of internal company policies.”

Goulard, the private practitioner in Southern California, named some pros and cons of the devices she’s tried. She said she liked Voyce’s functions but found the device too big and clunky. She tried Fitbark, but found it didn’t provide as much information as Voyce. At the other end of the spectrum, she finds PetPace to be “overkill. It has too much information.” All the same, she recommends it to pet owners because she believes that overall, smart collars are “an effective veterinary tool.”

For now, at least, Goulard is in the minority among her colleagues. In Dagan’s experience, demand for the PetPace collar is driven more by pet owners than veterinarians. He said veterinarians tend to be conservative about new treatments and technologies, and require assurances that no harm will be done, and that something effective will be accomplished.

Young at Vetrax says he’s found veterinarians to be interested in sensor technology, “even if they're not quite sure how to target its use within their practices.”

“Veterinarians will eventually join the digital revolution,” Dagan predicted, pointing to electronic medical record-keeping and digital radiography as examples of technologies that have “brought a clear and tangible benefit to veterinarians and patients.”

“I'm certain that the wearable technology will become a standard of care in the near future,” he declared, at the same time acknowledging that convincing evidence “will take time to develop.”

Editor's note: This article has been changed from the original to: correct the condition that was found in a cat as a result of monitoring by a PetPace collar; correct the name of a source at Vetrax to whom a quote was attributed; and clarify a journal publication citation.

VIN News Service commentaries are opinion pieces presenting insights, personal experiences and/or perspectives on topical issues by members of the veterinary community. To submit a commentary for consideration, email news@vin.com.